Executive Summary Final Report
Fairfax County, Fairfax City and Falls Church City, hereafter referred to as Fairfax or Fairfax Community, have come together to address a number of trends and critical issues, which are seriously impacting the long term care system. Most urgently, the growth over the next decade of baby boomers, the over 85 age group and younger adults with disabilities will tax the system’s infrastructure and capacity. In addition, there are many other issues such as the community’s increasing cultural diversity, confusing and oftentimes inaccessible services, new advances in medical technologies and a general lack of long term care insurance coverage which have contributed to this emerging crisis.
In response to these challenges, the Fairfax County Board of Supervisors chartered The Long Term Care Task Force to develop a Strategic Plan to meet the long term care needs of the Fairfax community.
Task Force Process
The Task Force was comprised of 40 members representing a wide range of organizations involved in providing or using long term care services. In structuring the Task Force emphasis was placed on diversity and inclusiveness.
The Task Force defined long term care as "the sum of policies and programs that provide social, health, rehabilitative, and supportive services over an extended period of time to individuals eighteen and over who are limited in performing major life activities". It then determined that in order to address the community’s emerging needs, the Strategic Plan should address the improvement and quality of services for the next ten years.
As a first step, Task Force members collectively considered several comprehensive analyses prepared by County staff. These analyses focused on issues such as demographic trends and factors affecting the need for long term care. The Task Force then established four criteria for assessing the need for quality long term care services.
It determined that services should be available, accessible, acceptable, and affordable for all adult residents.
As a next step, the Task Force formed five small committees to identify gaps in currently available services. Collectively over 190 gaps were identified by these committees. In addition, four community forums were held to gather input from interested citizens. In October 2000, an Interim Report was published which summarized the data analyses and the service gaps in the system in five separate areas: housing, transportation, supports to families, in-home services and community-based services. A copy of the committees’ reports is included in Appendix A. The Task Force then developed a list of assets in our community, which could be utilized in developing the Strategic Plan. A copy of this list is found in Appendix B. The Task Force then prioritized the gaps and broke into ten "incubator" groups, which were charged with developing goals, objectives and strategies for the highest priority gaps.
Once the Incubator Groups’ strategies were presented, it became apparent that they fell into four dominant themes; Increasing Public Awareness, Connecting People to Services, Promoting Independent, Supportive Living, and improving the Quality of the Long Term Care Workforce. A group was assigned to each of these themes and given responsibility for preparing a final set of relevant goals, objectives and strategies. These goals were adopted by the Task Force and received very positive support when presented to the community during a town meeting.
The Task Force also recognized a crosscutting issue; the need for a structure to oversee the implementation and maintenance of the recommended strategies. To this end, the Task Force urgently recommends that the Board of Supervisors establish a permanent Long Term Care Council. This body would be comprised of representatives of boards, authorities and commissions that have an interest in long term care as well as consumers and individuals from local advocacy and support organizations. It would guide and monitor the accomplishment of the recommendations of the Long Term Care Task Force. The Council would also be responsible for seeking funding sources and the development of new initiatives to take advantage of developments in the field of long term care to meet the changing needs of the population.
Theme One: Increasing Public Awareness. Fairfax Residents must be knowledgeable about the trends, issues, and realities associated with long term care so that they may plan, decide and act on their own behalf.
- Develop and conduct a comprehensive and ongoing campaign that will result in long term Care issues becoming a part of the awareness and everyday knowledge of Fairfax residents.
- Initiate and maintain a process, which will be responsible for the creation and dissemination of information relevant to long term care for adults. The information should be presented in appropriate formats and languages through various distribution channels and will make use of all available media (print, TV, radio, internet, etc.).
Theme 2: Connecting People to Services. Elderly persons, persons with disabilities and their caregivers must be connected to information and services that they need, when they need them, and at a level of intensity appropriate to their situation. The overall strategies for reaching this goal are to:
- Improve access to services by undertaking networking efforts, improving eligibility processes, and connecting people to services.
Integrate the delivery of a range of services essential to address
growing gaps in unmet service needs.
- Create a one-stop eligibility determination process.
- Form partnerships with provider organizations and educational institutions to address the growing gaps in available medical and ancillary services.
- Develop similar relationships with faith community organizations that provide health related activities.
- Improve access to public transportation services.
- Increase the availability of low-cost dental care.
Improve access to long term care services in Fairfax for persons of
diverse cultures and/or with limited English proficiency.
- Identify and adapt successful models in other multi-cultural communities for use in Fairfax County and build on current efforts within Fairfax.
Enhance skills in the use of technology in order to access services.
- Develop an educational strategy making use of the resources available in schools, libraries, businesses and not-for-profit organizations.
Theme 3: Promoting Independent, Supportive Living. Fairfax residents who are elderly or who have disabilities must be enabled to live as independently as possible. The overall strategy for reaching this goal is to increase the availability, affordability, and accessibility of supports that promote independence in the home and in the community. The Task Force developed twelve objectives in support of this strategy.
The objectives for this theme fall into four clusters: promoting independence in the community, promoting independence at home, promoting access in the community, and promoting quality environments for persons needing assistance with daily living.
Promoting Independence in the Community
- Increase and strengthen the availability, accessibility, and variety of community-based long term care options in response to the needs of people with disabilities.
- Increase the availability of support coordination, case management and consumer directed services as needed.
- Ensure adequate nutrition in the community by providing nutrition information, improving access to nutritional programs and increasing the total number of congregate meal sites.
Promoting Independence at Home
- Enhance, develop and coordinate supportive services in the home for persons with disabilities so they may have productive and fulfilling lives and maximize to the greatest extent possible home ownership.
- Make assistance available and affordable for persons with disabilities through advocacy by initiating or supporting legislation in the Virginia General Assembly.
- Modify homes to permit continued independence for residents.
Promoting Access to the Community
- Increase the supply of affordable, accessible housing.
- Develop an integrated transportation system that meets the needs of the elderly and adults with disabilities that is safe, acceptable, available, accessible, and affordable.
- Improve driving and pedestrian transport environments.
- Improve the quality of transportation services provided to elderly persons and persons with disabilities.
Promoting Quality Environments for People Needing Assistance with Daily Living
- Increase the quality and affordability of assisted living.
- Increase the quality and affordability of skilled nursing facilities.
Theme 4: Improving and Expanding the Long Term Care Workforce.The recruitment and retention of long term care providers must be increased and the quality of this workforce must be improved. An overall strategy and two objectives were developed in support of this goal.
- Overall Strategy: Develop a consortium for public and private providers of long term care services to share ideas and strategies for recruiting and retaining workers. The Consortium should be independent from the County and be a self-supporting public-private partnership that would have as its mission the improvement of the long term care workforce in Fairfax.
Provide incentives that improve recruitment and increase retention in
the long term care provider workforce.
- Improve the compensation of nurses, paraprofessional health care workers and other direct service providers.
- Increase the attractiveness of a career in the field of long term care.
- Improve working conditions by establishing standards for accreditation of long term care organizations.
- Provide transportation, which is a significant problem for many persons who are working in these organizations.
Implement measures to improve the quality of the long term care
- Promote health careers.
- Provide increased training options.